SlideShare une entreprise Scribd logo
1  sur  11
Myomectomy As an Alternative to Hysterectomy for Women Who Have Completed Childbearing: A Pilot Study David Blair Toub, M.D. Dept of Obstetrics and Gynecology  Pennsylvania Hospital
Uterine Fibroids: ,[object Object],[object Object],[object Object],[object Object]
Why Is Myomectomy Not Preferred? ,[object Object],[object Object],[object Object],[object Object]
Hysterectomy Risks: ,[object Object],[object Object],[object Object],[object Object]
Patient Population: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Exclusions: ,[object Object],[object Object],[object Object],[object Object]
Operative Technique: ,[object Object],[object Object],[object Object],[object Object],[object Object]
Results: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Conclusions: ,[object Object],[object Object],[object Object]
“ The uterus has but one function- Reproduction. After the last planned pregnancy, the uterus becomes a useless, bleeding, symptom-producing, potentially cancer-bearing organ and therefore should be removed.” Wright, Obstet Gynecol 33:560, 1969
“ Since cure without deformity or loss of  function must ever be surgery’s highest ideal,  the general proposition that myomectomy is a  greater surgical achievement than hysterectomy is incontestable.” Bonney, 1931

Contenu connexe

Tendances

Tendances (20)

MANAGEMENT OF VAULT PROLAPSE BY DR SHASHWAT JANI
MANAGEMENT OF VAULT PROLAPSE BY DR SHASHWAT JANIMANAGEMENT OF VAULT PROLAPSE BY DR SHASHWAT JANI
MANAGEMENT OF VAULT PROLAPSE BY DR SHASHWAT JANI
 
Vesico vaginal fistula
Vesico vaginal fistulaVesico vaginal fistula
Vesico vaginal fistula
 
Fibroid complicating pregnancy
Fibroid complicating pregnancyFibroid complicating pregnancy
Fibroid complicating pregnancy
 
OVARIAN TUMOURS
OVARIAN TUMOURSOVARIAN TUMOURS
OVARIAN TUMOURS
 
Cervical stitches
Cervical stitchesCervical stitches
Cervical stitches
 
Vulvovaginal hematoma - Dr Mitra Saxena
Vulvovaginal hematoma  - Dr Mitra SaxenaVulvovaginal hematoma  - Dr Mitra Saxena
Vulvovaginal hematoma - Dr Mitra Saxena
 
Rectovaginal fistulas
Rectovaginal fistulasRectovaginal fistulas
Rectovaginal fistulas
 
Ovarian cysts
Ovarian cystsOvarian cysts
Ovarian cysts
 
Genital tuberculosis
Genital tuberculosisGenital tuberculosis
Genital tuberculosis
 
Deep transverse arrest
Deep transverse arrestDeep transverse arrest
Deep transverse arrest
 
Total Laparoscopic Hysterectomy- Tips, Tricks & Techniques
Total Laparoscopic Hysterectomy- Tips, Tricks & TechniquesTotal Laparoscopic Hysterectomy- Tips, Tricks & Techniques
Total Laparoscopic Hysterectomy- Tips, Tricks & Techniques
 
Mullerian anomalies
Mullerian anomaliesMullerian anomalies
Mullerian anomalies
 
Hypertrophic elongated cervix (elongation of cervix)
Hypertrophic elongated cervix (elongation of cervix)Hypertrophic elongated cervix (elongation of cervix)
Hypertrophic elongated cervix (elongation of cervix)
 
Prior cesarean delivery (VBAC)
Prior cesarean delivery (VBAC)Prior cesarean delivery (VBAC)
Prior cesarean delivery (VBAC)
 
Caesarean section
Caesarean sectionCaesarean section
Caesarean section
 
Cervical incompetence
Cervical incompetenceCervical incompetence
Cervical incompetence
 
Medical Management of Fibroids
Medical Management of FibroidsMedical Management of Fibroids
Medical Management of Fibroids
 
Pelvic ureter
Pelvic ureterPelvic ureter
Pelvic ureter
 
ectopic pregnancy
ectopic pregnancyectopic pregnancy
ectopic pregnancy
 
Intrauterine death
Intrauterine deathIntrauterine death
Intrauterine death
 

En vedette

Uterine artery embolisation
Uterine artery embolisationUterine artery embolisation
Uterine artery embolisation
meducationdotnet
 
Hysterectomy Powerpoint
Hysterectomy PowerpointHysterectomy Powerpoint
Hysterectomy Powerpoint
mandy rivas
 
Bideoaetahezkuntza
BideoaetahezkuntzaBideoaetahezkuntza
Bideoaetahezkuntza
patricia
 
Đi tìm ý nghĩa cuộc sống
Đi tìm ý nghĩa cuộc sốngĐi tìm ý nghĩa cuộc sống
Đi tìm ý nghĩa cuộc sống
bita89
 
Givven - The Viral Promotion Application
Givven - The Viral Promotion ApplicationGivven - The Viral Promotion Application
Givven - The Viral Promotion Application
damanit
 
Presentacio mediambient 2010
Presentacio mediambient 2010Presentacio mediambient 2010
Presentacio mediambient 2010
mediambient2010
 

En vedette (20)

Laparoscopic myomectomy
Laparoscopic myomectomyLaparoscopic myomectomy
Laparoscopic myomectomy
 
Uterine Fibroid Embolization
Uterine Fibroid EmbolizationUterine Fibroid Embolization
Uterine Fibroid Embolization
 
Uterine artery embolisation
Uterine artery embolisationUterine artery embolisation
Uterine artery embolisation
 
Laparascopic Hysterectomy, technical aspect
Laparascopic Hysterectomy, technical aspectLaparascopic Hysterectomy, technical aspect
Laparascopic Hysterectomy, technical aspect
 
Myoma & preg
Myoma & pregMyoma & preg
Myoma & preg
 
Fibroid complicating pregnancy
Fibroid complicating pregnancyFibroid complicating pregnancy
Fibroid complicating pregnancy
 
Total abdominal hysterectomy with bilateral salpingo-oophorectomy.
Total abdominal hysterectomy with bilateral salpingo-oophorectomy.Total abdominal hysterectomy with bilateral salpingo-oophorectomy.
Total abdominal hysterectomy with bilateral salpingo-oophorectomy.
 
Hysterectomy Powerpoint
Hysterectomy PowerpointHysterectomy Powerpoint
Hysterectomy Powerpoint
 
Uterine fibroids
Uterine fibroidsUterine fibroids
Uterine fibroids
 
History taking - For Surgical patients
History taking - For Surgical patientsHistory taking - For Surgical patients
History taking - For Surgical patients
 
Bideoaetahezkuntza
BideoaetahezkuntzaBideoaetahezkuntza
Bideoaetahezkuntza
 
Đi tìm ý nghĩa cuộc sống
Đi tìm ý nghĩa cuộc sốngĐi tìm ý nghĩa cuộc sống
Đi tìm ý nghĩa cuộc sống
 
Givven - The Viral Promotion Application
Givven - The Viral Promotion ApplicationGivven - The Viral Promotion Application
Givven - The Viral Promotion Application
 
SXSW Cultures of Advocacy
SXSW Cultures of AdvocacySXSW Cultures of Advocacy
SXSW Cultures of Advocacy
 
JSR life science product of Magnetic beads
JSR life science product of Magnetic beadsJSR life science product of Magnetic beads
JSR life science product of Magnetic beads
 
Event handling using jQuery
Event handling using jQueryEvent handling using jQuery
Event handling using jQuery
 
Henry matisse
Henry matisseHenry matisse
Henry matisse
 
Overview-ISAC
Overview-ISACOverview-ISAC
Overview-ISAC
 
Kelsey
Kelsey Kelsey
Kelsey
 
Presentacio mediambient 2010
Presentacio mediambient 2010Presentacio mediambient 2010
Presentacio mediambient 2010
 

Similaire à myomectomy

Management of endometrial hyperplasia
Management of endometrial hyperplasiaManagement of endometrial hyperplasia
Management of endometrial hyperplasia
Ahmad Saber
 
effective health care review
effective health care revieweffective health care review
effective health care review
Adina Chen Bar
 

Similaire à myomectomy (20)

effectiveness of operative hysteroscopy in primary infertility on pregnancy rate
effectiveness of operative hysteroscopy in primary infertility on pregnancy rateeffectiveness of operative hysteroscopy in primary infertility on pregnancy rate
effectiveness of operative hysteroscopy in primary infertility on pregnancy rate
 
Case Study: Recurrent myoma with menorrhagia
Case Study: Recurrent myoma with menorrhagiaCase Study: Recurrent myoma with menorrhagia
Case Study: Recurrent myoma with menorrhagia
 
Laparoscopy and fertility
Laparoscopy and fertilityLaparoscopy and fertility
Laparoscopy and fertility
 
leiomyomas
leiomyomasleiomyomas
leiomyomas
 
Abdominal ve Vajinal Histerektomi - www.jinekolojivegebelik.com
Abdominal ve Vajinal Histerektomi - www.jinekolojivegebelik.comAbdominal ve Vajinal Histerektomi - www.jinekolojivegebelik.com
Abdominal ve Vajinal Histerektomi - www.jinekolojivegebelik.com
 
Fertility management in ovarian endometrioma
Fertility management in ovarian endometrioma Fertility management in ovarian endometrioma
Fertility management in ovarian endometrioma
 
Management of endometrial hyperplasia
Management of endometrial hyperplasiaManagement of endometrial hyperplasia
Management of endometrial hyperplasia
 
SAVE THE UTERUS
SAVE THE UTERUSSAVE THE UTERUS
SAVE THE UTERUS
 
sterilization
sterilizationsterilization
sterilization
 
Hysterectomy.pptx
Hysterectomy.pptxHysterectomy.pptx
Hysterectomy.pptx
 
effective health care review
effective health care revieweffective health care review
effective health care review
 
Pre-ART Management of Fibroids
Pre-ART Management of FibroidsPre-ART Management of Fibroids
Pre-ART Management of Fibroids
 
Hysterectomy decision el-hennawy
Hysterectomy decision el-hennawyHysterectomy decision el-hennawy
Hysterectomy decision el-hennawy
 
The Role of Surgery in the Management of Ovarian Cancer
The Role of Surgery in the Management of Ovarian CancerThe Role of Surgery in the Management of Ovarian Cancer
The Role of Surgery in the Management of Ovarian Cancer
 
Fibroids and infertility
Fibroids and infertilityFibroids and infertility
Fibroids and infertility
 
Fibroid & infertility
Fibroid & infertilityFibroid & infertility
Fibroid & infertility
 
Dr nasrin.ogsb2014
Dr nasrin.ogsb2014Dr nasrin.ogsb2014
Dr nasrin.ogsb2014
 
Hysterectomy
HysterectomyHysterectomy
Hysterectomy
 
Endometrial cancer in a woman undergoing hysteroscopy for recurrent ivf failure
Endometrial cancer in a woman undergoing hysteroscopy for recurrent ivf failureEndometrial cancer in a woman undergoing hysteroscopy for recurrent ivf failure
Endometrial cancer in a woman undergoing hysteroscopy for recurrent ivf failure
 
Laparoscopy 1
Laparoscopy  1Laparoscopy  1
Laparoscopy 1
 

Plus de Karl Daniel, M.D. (20)

menstrual cycle
menstrual cyclemenstrual cycle
menstrual cycle
 
vulvo vaginal infection
vulvo vaginal infectionvulvo vaginal infection
vulvo vaginal infection
 
vesicular molle 2
vesicular molle 2vesicular molle 2
vesicular molle 2
 
vesicular molle 1
vesicular molle 1vesicular molle 1
vesicular molle 1
 
Sexually Transmitted Infections
Sexually Transmitted InfectionsSexually Transmitted Infections
Sexually Transmitted Infections
 
Screening for Female Genital Tract Malignancy
Screening for Female Genital Tract MalignancyScreening for Female Genital Tract Malignancy
Screening for Female Genital Tract Malignancy
 
vaginal prolapse
vaginal prolapsevaginal prolapse
vaginal prolapse
 
prevention Cervical cancer
prevention Cervical cancerprevention Cervical cancer
prevention Cervical cancer
 
ovarian tumor
ovarian tumorovarian tumor
ovarian tumor
 
Contemporary Use of the Pessary
Contemporary Use of the PessaryContemporary Use of the Pessary
Contemporary Use of the Pessary
 
management of cancer of cervix
management of cancer of cervixmanagement of cancer of cervix
management of cancer of cervix
 
fibroids
fibroidsfibroids
fibroids
 
endometriosis
endometriosisendometriosis
endometriosis
 
DnC
DnCDnC
DnC
 
carcinoma vulva
carcinoma vulvacarcinoma vulva
carcinoma vulva
 
amenorrhea
amenorrheaamenorrhea
amenorrhea
 
adenomyosis
adenomyosisadenomyosis
adenomyosis
 
Evidence Based Diagnosis
Evidence Based DiagnosisEvidence Based Diagnosis
Evidence Based Diagnosis
 
HORMONE REPLACEMENT THERAPY 2
HORMONE REPLACEMENT THERAPY 2HORMONE REPLACEMENT THERAPY 2
HORMONE REPLACEMENT THERAPY 2
 
HORMONE REPLACEMENT THERAPY
HORMONE REPLACEMENT THERAPY HORMONE REPLACEMENT THERAPY
HORMONE REPLACEMENT THERAPY
 

myomectomy

  • 1. Myomectomy As an Alternative to Hysterectomy for Women Who Have Completed Childbearing: A Pilot Study David Blair Toub, M.D. Dept of Obstetrics and Gynecology Pennsylvania Hospital
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
  • 10. “ The uterus has but one function- Reproduction. After the last planned pregnancy, the uterus becomes a useless, bleeding, symptom-producing, potentially cancer-bearing organ and therefore should be removed.” Wright, Obstet Gynecol 33:560, 1969
  • 11. “ Since cure without deformity or loss of function must ever be surgery’s highest ideal, the general proposition that myomectomy is a greater surgical achievement than hysterectomy is incontestable.” Bonney, 1931